Business Health Checkup Application

Pathfinder Metrics offers a free business health checkup at our office in Moorpark, CA. If you would like to have a business health checkup for your business, please complete the following questionnaire. Once received, we will contact you to set up a convenient appointment. All information will be treated confidentially and according to our Privacy Policy. You can read our privacy policy at www.PathfinderMetrics.com.
Company Name:
Contact Name:
Contact Title:
Contact Phone:
Contact Fax:
Contact Email:
Company Mailing Address:
Company Physical Address:
Industry:
 Manufacturing Construction
Service Distribution
Retail Engineering
Non-Profit Government
Describe your products and/or services:
Date Company Started:
Legal Form:
Proprietorship C-Corp
Non-Profit State Agency
Federal Agency County Agency
Municipality O LLC
Partnership S-Corp
Number of Employees:
What are the qualifications of your most senior in-house accounting staff?
Experience: Education:
0-2 yrs
High School
 
3-6 yrs
2 yrs College
 
7-10 yrs
BA or BS degree
 
11+ yrs
MBA or higher
List major competitors:
1.
2.
3.
4.
5.
How do you differentiate your business from your competitors to give you a competitive advantage?

Businesses and business owners often have many unmet needs. Please check off the following needs that are currently present in your business:

Lacking of access to expertise in Key areas:

Sales & Marketing
 
Production
Legal
Finance
Human Resources
Engineering
Research & Development
Organization Management/Performance Management
Strategic Planning
Strategic Plan implementation
Information & Management Reporting
Information Technology support
Facilities Management
Logistics & Inventory Management
Risk Management & Insurance
Health & Safety
Addition Cash/financing
Improved sales & marketing effectiveness
Improved profit margins/better understanding of where profits are being made and lost
Lower or more efficient overhead costs
Better banking relationships
Better investor relationships
Better employee relationships
Higher employee productivity
An exit strategy from the business
Acquisition of another business
To start a new business or division
Risk management issues:
Workers Comp Insurance
Product Liability Insurance
Professional Liability Insurance
General Liability Insurance
Safety concerns/issues
Legal issues pending
Against you or your business
Against others by you or your business
Strategic Planning
Strategic plan implementation
Balancing your personal life with your business requirements
What were total sales for last year?
What sales are anticipated for this year?
Please fill in the following boxes. Put a name in every box regardless of whether the person is listed in other boxes or if the person is a non-employee providing professional services for that area. You don’t necessarily call them a Director, but they are the person in your company who is responsible for that function:


If you have your accounting on QuickBooks or Peachtree, it may be useful to bring a backup file to your appointment. Otherwise, please be sure to bring your income statement and balance sheet showing year-to-date results or last year’s results.
Thank you for your interest. We will be contacting you shortly to set an appointment.